Patient demand

"Almost every single patient I have has asked about it," said Dr. Lori Montgomery, a Calgary-based chronic pain physician who prescribes medical marijuana to a handful of her patients with nerve pain. She does so judiciously.

"I do think there are situations when a patient has tried everything else, nothing else works and they're low risk in terms of the things we think put people at risk of adverse effects of cannabis, then its worth a try," she said.

Doctors more willing to discuss

Montgomery — who regularly talks to health-care providers about cannabis — says physicians affiliated with some of Calgary's medical marijuana clinics are prescribing to a lot of people. But she believes community-based doctors are now more open to it.

"Over the last year or two, people are more comfortable having that conversation," she said.

"There are increasingly individual physicians who are saying, for a patient that I know well and I'm comfortable with their risk factors, I'd be prepared to authorize it for one or two patients, which is different from a year ago."

According to Montgomery, that's driven by a number of factors including improved access to information.

"We have a lot more opportunities to learn about cannabis now, as doctors," she said. "We have a lot more opportunities to figure out how to instruct patients about safer patterns of use, probably as compared to a year ago."

It's also an effort to reduce harm, she says, as more physicians recognize patients can access marijuana with our without their help.

CMA urges cautious approach

The Canadian Medical Association (CMA) raised warning flags about the practise of prescribing medical marijuana years ago and continues to urge caution.

"There's a constellation of chemicals here that we don't really know exactly what it is, what it does and how it interacts with other diseases. So it's a bit of a problem to prescribe it," said CMA president Dr. Granger Avery.

According to Avery, while there are anecdotal reports that cannabis has helped some people, there isn't enough scientific research to prove those claims.

Dr. Montgomery agrees a cautious approach is necessary. With 500 physicians authorized to treat 10,000 Albertans, she worries there are some doctors who are prescribing cannabis without the proper scrutiny or follow-up.

"I would be happier if more people were authorizing for fewer patients. That, to me, would indicate that the authorizations are being done by someone who has a relationship with the patient and really understands the situation."